1. Has your doctor ever said that you have a heart condition OR high blood pressure? *
2. Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical activity? *
3. Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? Please answer NO if your dizziness was associated with over-breathing (including during vigorous exercise). *
4. Have you ever been diagnosed with another chronic medical condition(other than heart disease or high blood pressure)? *
5. Are you currently taking prescribed medications for a chronic medical condition? *
6.Do you have a bone or joint problem that could be made worse by becoming more physically active?Please answer NO if you had a joint problem in the past, but it does not limit your current ability to be physically active. For example, knee, ankle, shoulder or other. *
7. Has your doctor ever said that you should only do medically supervised physical activity? *
By checking this box I confirm that I have read, understood and completed this questionnaire. Any question that I had were answered to my full satisfaction.
